Objective:

To compare the precision of implant positioning in robotic-assisted total hip arthroplasty (RATHA) versus conventional total hip arthroplasty (COTHA) and assess patient-reported outcomes and complication rates, highlighting the implications of precision on clinical outcomes.

Key Findings:

• No significant differences in patient-reported pain, hip function, or activity between RATHA and COTHA.
• Conventional procedures generally required less operative time (e.g., 104 min vs 69 min).
• Robotic-assisted surgery showed smaller limb length discrepancies and greater implant positioning precision.
• Radiographic outcomes indicated improved precision for robotic-assisted procedures, but clinical outcomes were similar.
• Heterogeneity in robotic platforms may limit generalizability, and the learning curve and increased costs associated with robotic surgery should be considered.

Interpretation:

While robotic-assisted surgery demonstrated improved radiographic precision, it did not translate into significant differences in short- or medium-term clinical outcomes compared to conventional surgery, suggesting that longer follow-up may be necessary to determine clinical significance.

Limitations:

• Small number of high-quality randomized trials.
• Heterogeneous study designs and inconsistent complication reporting.
• Short follow-up periods.
• Potential conflicts of interest in included studies, which may affect interpretation of findings.

Conclusion:

Both RATHA and COTHA yielded similar clinical outcomes, but robotic-assisted procedures had advantages in radiological precision.